Treatment of Subacute Bacterial Endocarditis by Penicillin

Serological Classification of Viridans Streptococci from Subacute Bacterial Endocarditis, Teeth, and Throats

“…It would, however, appear from our results that streptococci of Group Ila, the largest group in streptococci from teeth and throats, have less tendency to produce subacute bacterial endocarditis than the streptococci of the other four groups. These observations nevertheless give further support to the view we have previously expressed in common with others that the viridans streptococci of subacute bacterial endocarditis come from the region of the mouth (Ward, Meanock, Selbie, and Simon, 1946). In the earlier communication we noted the association between dental sepsis and the initiation of the symptoms of subacute bacterial endocarditis, and here we have not only confirmed the finding of Okell and Elliott (1935) that viridans streptococci may escape into the blood stream during dental extraction but have also found that these streptococci belong to the same serological groups as those of subacute bacterial endocarditis.…”

“…But he must leave it to others to judge in how far he has succeeded. In a previous report on the treatment of 18 cases of subacute bacterial endocarditis with penicillin (Ward, Meanock, Selbie, and Simon, 1946) it was stated that the biochemical characters of 14 strains of streptococci isolated from these cases indicated that some were similar to Streptococcus salivarius, described by Andrewes and Horder (1906) as the most common organism of this type in the mouth and nasopharynx and of frequent occurrence in subacute bacterial endocarditis, while the others were similar to a number of strains isolated by Okell and Elliott (1935) from cases of subacute bacterial endocarditis and from blood cultures in cases of dental sepsis. It thus appeared likely that our strains of streptococci were of a type often found in subacute bacterial endocarditis and of common occurrence in the region of the mouth.…”

Teeth, Streptococcus Viridans, and Subacute Bacterial Endocarditis

“…In a varying proportion of cases in all published series a dental extraction has been specifically identified as the causa causans (Rushton, 1930;Abrahamson, 1931;Okell and Elliott, 1935;Feldman and Trace, 1938;Ward et al, 1946;Anderson and Keefer, 1948;Cates and Christie, 1951). That such cases should occur in specific relation to dental extractions is clearly a reflection upon both medical and dental practitioners, in that these patients are in most cases known to have acquired or congenital cardiac lesions, and that for such patients dental extractions are significantly hazardous.…”